With all the medical and media attention given to depression over the past two decades, another equally commonplace condition has been widely overlooked: anxiety disorder.
This is all the more remarkable when you consider the amount of pressure so many of us face in our daily lives. In today’s hectic, fast-paced, stressful world, you would think anxiety-related disorders would pose a far greater threat to our society than depression.
And it turns out you’d be right.
According to the National Institute of Mental Health, 40 million American adults, or about 18.1% of people in this age group in any given year, suffer from some form of anxiety disorder.* By comparison, only 14.8 million American adults, or about 6.7% of the US adult population, suffer from major depression.* †
In other words, the number of adults in this country currently suffering from some form of anxiety disorder is almost three times the number of people stricken with major depression.
This is not to diminish the problem of depression. In fact, anxiety disorders frequently co-occur with depressive disorders or substance abuse.* And most people who suffer from one type of anxiety disorder also have another type of anxiety disorder, which is what makes the information you’re about to learn so timely, relevant, and valuable.
As many clinicians will tell you, the range of drugs available to effectively treat anxiety remains relatively limited. Many are potentially addictive and lose efficacy over time, like the benzodiazepines Valium®, Xanax®, and Klonopin®. Others come with a host of undesirable side effects, including dry mouth, cognitive or memory impairment, and loss of sex drive.
Pioneering and visionary psychiatrist Dr. Henry Emmons—first profiled in Life Extension Magazine® over three years ago—has remained at the forefront in identifying natural interventions to restore calm in the face of stress, with minimal side effects.
In this exclusive excerpt from his most recent work, The Chemistry of Calm, Dr. Emmons presents a comprehensive set of natural compounds, along with recommended dosages and regimens, to effectively combat the hidden scourge of anxiety disorder.
Using medications to try to improve brain chemistry can offer relief, at least in the short term. But medications do not restore normal levels of neurotransmitters, nor even promote normal function. They manipulate the brain chemistry to achieve their desired effects.
SSRIs, for example, prevent the reuptake (or recycling) of serotonin from the space between the nerve cells (the synapse). This allows the chemical to remain in the area of activity for a longer period of time. And the benzodiazepines, such as Valium, Ativan, and Xanax®, work by stimulating the GABA receptors, thus mimicking the calming effects of GABA in the brain.
With time, the brain accommodates to medications and they often lose their effectiveness, requiring higher doses or different drugs. When you try to stop them, there are frequently withdrawal symptoms that feel worse than the original problem.
When the brain produces a neurotransmitter, it starts with a raw ingredient, usually an amino acid from the diet or another chemical that is already present in the brain. Enzymes are then used to convert the amino acid into the needed brain chemical. By understanding this process in detail, we can take measures to assure an ample supply of the raw ingredients and also enhance the activity of the enzymes. There are various cofactors, for example, that help the enzymes work faster (e.g., the B vitamins).
Understanding the function of nutrients allows for more subtle and natural interventions than standard medical practice, and if they are taken appropriately, I believe that they can work better and have fewer side effects than medication.
The Talking Brain
The neurotransmitters are chemicals that enable the different parts of the brain to stay in touch with one another and coordinate their roles. The table below summarizes the key players in the fear circuitry, what they do, and how to support them nutritionally.
Calm Yourself: Glutamate and GABA
Our bodies are truly elegant in their design, and this is especially apparent with brain function. One common element of this design is a binary system, wherein one chemical activates a process while its partner turns it off again. That is true of the brain chemicals glutamate and GABA, which together account for over 80 percent of brain activity. Glutamate accelerates brain activity—it is excitatory. GABA, on the other hand, puts the brakes on brain activity—it is inhibitory. Together, they keep the brain humming along at just the right pace—not too fast, not too slow.
If you have developed anxiety, then you know that your balance of these two chemicals has been thrown off and the brain’s activity level is turned up too high, at least in some areas of the brain.
The balancing supplements for glutamate and GABA include the amino acids taurine, GABA, and L-theanine; the antioxidants NAC and green tea; vitamins B6 and D; the minerals magnesium and zinc; omega-3 fatty acids; and several herbal therapies.
How Do You Know if Glutamate and GABA Are Imbalanced?
Remember that all of these chemicals are necessary and even beneficial when they are in balance and working properly. But it is possible to have too much glutamate for your own good. If it becomes truly excessive, then the overactivation that results can become outright dangerous to the cells. Glutamate then changes from being simply excitatory to becoming excitotoxic, and this may result in the premature death of the cell.1 This process may be related to the later development of neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease.2 This is not a good state for your brain to be in for very long.
Additionally, your GABA levels may have fallen too low so that there is not enough inhibition to keep glutamate in check. Like a car that has lost its brake fluid, you may have lost the ability to slow things down. To remedy this imbalance, we can find ways to either reduce the effects of glutamate, enhance the activity of GABA, or both.
The balancing supplements for glutamate and GABA include the amino acids taurine, GABA, and L–theanine; the antioxidants NAC and green tea; vitamins B6 and D; the minerals magnesium and zinc; omega-3 fatty acids; and several herbal therapies.
Disarm Yourself: Reduce Norepinephrine
Norepinephrine raises our level of alertness and arousal. That is well and good if you’re doing something like hunting or evading capture, but not helpful if you are speaking in front of a group or if you have developed panic anxiety for any reason. With depression there is often too little norepinephrine, but in anxiety it is frequently elevated and needs to be toned down.
At an emotional level, you may feel panicky, as if something awful is about to happen. And mentally, your mind may go blank as you find that you can’t think clearly or remember things, no matter how hard you try.
You can tone down the effects of norepinephrine by taking the amino acid L-theanine, the antioxidant NAC, inositol, and the omega-3 fatty acids. You should also avoid caffeine.
Reward Yourself: Balance Dopamine
The effects of dopamine are more complex than those of norepinephrine, at least in regard to anxiety. In some ways, they have a similar function. Both tend to be energizing and aid in mental focus and concentration. Both can aggravate anxiety when levels are way too high. But dopamine has some beneficial effects against anxiety as well, such as improving motivation and the experience of pleasure. Unless dopamine becomes really excessive, your anxiety may improve if you gently boost your dopamine levels.
Signs of dopamine deficiency include feeling apathetic and fatigued, difficulty losing weight, feeling unmotivated (as with exercise), low sex drive, and general difficulty getting pleasure from things. If you have these signs along with anxiety, consider taking these measures to boost dopamine function: B vitamins, omega-3 fatty acids, L-theanine.
Soothe Yourself: Boost Serotonin
Nearly everyone feels better when their serotonin levels are optimal. It has such a wide array of functions, involved with everything from sleep to appetite to impulse control to sexual desire. It is the brain chemical that helps soothe us when we feel stressed or threatened, and it offers considerable protection to the brain against the damaging effects of cortisol.
Because it is such a key brain chemical, the signs of serotonin depletion are many: insomnia (or irregular circadian rhythms); craving sweets and other carbohydrates; frequent muscle aches and pains; impulsive behaviors; moodiness, especially sadness, anxiety, and irritability; feeling emotionally sensitive or vulnerable; feeling insecure, lacking self-confidence; and low stress tolerance.
Most people with anxiety, especially if their mood is low as well, may benefit by boosting their serotonin levels. Consider taking the following supplements: the amino acid L-tryptophan or the related precursor 5-HTP, the hormone DHEA, the B vitamins and vitamin D, and omega-3 fats.
* Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry. 2005 Jun;62(6):617-27.
† U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. http://www.census.gov/popest/national/asrh/